Evidence map›Paper›PMID 33784346›Full record

SynthesisPloS one2021

Intensive versus less-intensive antileukemic therapy in older adults with acute myeloid leukemia: A systematic review.

Yaping Chang, Gordon H Guyatt, Trevor Teich, Jamie L Dawdy, Shaneela Shahid, Jessica K Altman, Richard M Stone, Mikkael A Sekeres, Sudipto Mukherjee, Thomas W LeBlanc and 9 more

Open access · goldAbstract readComparative StudyMeta-AnalysisSystematic Review
In one paragraph

Synthesis in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors at 14 institutions in 2 countries.

Yaping ChangDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0002-0549-5087
Gordon H GuyattDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Trevor TeichDrexel University College of Medicine, Philadelphia, Pennsylvania, United States of America.
Jamie L DawdySchool of Nursing, McMaster University, Hamilton, Ontario, Canada.
Shaneela ShahidDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Jessica K AltmanDivision of Hematology/Oncology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America.
Richard M StoneDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, United States of America.
Mikkael A SekeresLeukemia Program, Cleveland Clinic, Cleveland, Ohio, United States of America.
Sudipto MukherjeeLeukemia Program, Cleveland Clinic, Cleveland, Ohio, United States of America.
Thomas W LeBlancDivision of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America.
Gregory A AbelDivision of Hematologic Malignances and Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, United States of America.
Christopher S HouriganNational Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
Mark R LitzowDivision of Hematology, Mayo Clinic, Rochester, Minnesota, United States of America.
Laura C MichaelisDivision of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America.
Shabbir M H AlibhaiDepartment of Medicine, University Health Network & University of Toronto, Toronto, Ontario, Canada.
Pinkal DesaiWeill Cornell Medicine, New York City, New York, United States of America.
Rena BucksteinOdette Cancer Centre, Division of Medical Oncology and Hematology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Janet MacEachernGrand River Regional Cancer Centre, Kitchener, Ontario, Canada.
Romina Brignardello-PetersenDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Impact · CACleveland Clinic · USDana-Farber Cancer Institute · USCornell University · USDrexel University · USDuke University · USGrand River Hospital · CAMayo Clinic · USMcMaster University · CAMedical College of Wisconsin · USNational Institutes of Health · USNorthwestern University · USSunnybrook Health Science Centre · CAUniversity Health Network · CA

Funding

TYROSINE KINASE ONCOGENESIS IN MYELOID LEUKEMIAP01CA066996 · NCI · DANA-FARBER CANCER INSTITUTE · PI SCOTT A ARMSTRONG · 1996 to 2026
$52.5M
Detection, prevention and treatment of acute myeloid leukemia (AML) relapse.ZIAHL006163 · NHLBI · NATIONAL HEART, LUNG, AND BLOOD INSTITUTE · PI HOURIGAN, CHRISTOPHER · 2013 to 2023
$21.0M
NCI NIH HHS P01 CA066996
6 · The paper itself

Abstract

To compare the effectiveness and safety of intensive antileukemic therapy to less-intensive therapy in older adults with acute myeloid leukemia (AML) and intermediate or adverse cytogenetics, we searched the literature in Medline, Embase, and CENTRAL to identify relevant studies through July 2020. We reported the pooled hazard ratios (HRs), risk ratios (RRs), mean difference (MD) and their 95% confidence intervals (CIs) using random-effects meta-analyses and the certainty of evidence using the GRADE approach. Two randomized trials enrolling 529 patients and 23 observational studies enrolling 7296 patients proved eligible. The most common intensive interventions included cytarabine-based intensive chemotherapy, combination of cytarabine and anthracycline, or daunorubicin/idarubicin, and cytarabine plus idarubicin. The most common less-intensive therapies included low-dose cytarabine alone, or combined with clofarabine, azacitidine, and hypomethylating agent-based chemotherapy. Low certainty evidence suggests that patients who receive intensive versus less-intensive therapy may experience longer survival (HR 0.87; 95% CI, 0.76-0.99), a higher probability of receiving allogeneic hematopoietic stem cell transplantation (RR 6.14; 95% CI, 4.03-9.35), fewer episodes of pneumonia (RR, 0.25; 95% CI, 0.06-0.98), but a greater number of severe, treatment-emergent adverse events (RR, 1.34; 95% CI, 1.03-1.75), and a longer duration of intensive care unit hospitalization (MD, 6.84 days longer; 95% CI, 3.44 days longer to 10.24 days longer, very low certainty evidence). Low certainty evidence due to confounding in observational studies suggest superior overall survival without substantial treatment-emergent adverse effect of intensive antileukemic therapy over less-intensive therapy in older adults with AML who are candidates for intensive antileukemic therapy.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsLeukemia, Myeloid, AcuteAgedCytarabineHumansRandomized Controlled Trials as TopicCytarabine

Identifiers

PMID33784346
PMCPMC8009379
OpenAlexW3151461673

What OpenQuestion holds

Textmetadata
LicenceCC0
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.